Overview. Dr. Zink s Respiratory/Circulatory Model and the Common Compensatory Pattern. Osteopathic Medicine. J. Gordon Zink, DO, FAAO 4/16/2010

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1 Dr. Zink s Respiratory/Circulatory Model and the Common Compensatory Pattern Boyd R. Buser, DO, FACOFP American Academy of Osteopathy Annual Convocation 2010 Overview J. Gordon Zink, the man A.T. Still on Air and Fluids Respiratory/Circulatory Concepts The Common Compensatory Pattern J. Gordon Zink, DO, FAAO, Graduate of PCOM Practiced in rural Pennsylvania Faculty at DMU-COM Awarded A.T. Still Medallion in 1981 J. Gordon Zink, DO, FAAO Garbage Man Fluid Freak Lymphomaniac Osteopathic Medicine A.T. Still - Effect of somatic system on movement of air and fluids in the body 1

2 Historical Perspective D.D. Palmer - Effect of spinal misalignment on nerve function The rule of the artery must be absolute, universal and unobstructed, or disease will be the result. - Autobiography The osteopathic physician s foundation is that all the blood must move all the time in all parts to and from all organs. Research and Practice We strike at the source of life and death when we go into the lymphatics. - Philosophy of Osteopathy A full and complete supply of arterial blood must be generated and delivered to all parts, organs, and glands, by the channels called the arteries. And when it has done its work, then without delay the veins must return all to the heart and lungs for renewal. Philosophy of Osteopathy This diaphragm says, By me you live and by me you die. I hold in my hand the powers of life and death, acquaint now thyself with me and be at ease. Philosophy of Osteopathy 2

3 Respiratory/Circulatory Concepts Significance ifi of somatic dysfunction determined by effect on movement of air and fluids Circulatory Systems High pressure - Arterial Low pressure - Venous and Lymphatic Somatic Dysfunction Distortion of TAP Cylinder Distortion of Thoraco-abdomino-pelvic (TAP) Cylinder Decreased Diaphragmatic Amplitude Decreased Diaphragmatic Amplitude Decreased Thoracoabdominal Pressure Gradient Decreased Thoracoabdominal Pressure Gradient Passive Congestion of Venous and Lymphatic Systems 3

4 Passive Congestion of Venous and Lymphatic Systems Build-up of Waste Products of Cellular Respiration Build-up of Waste Products of Cellular Respiration Compromise of Cellular Environment Respiratory/Circulatory Evaluation Compromise of Cellular Environment Suboptimal Function of Self-healing Properties History Vague sense of malaise Morning headache or backache that disappears with activity Non-restorative sleep Normal lab evaluation Respiratory/Circulatory Evaluation Physical Exam Increased lumbar lordosis Shallow breathing with increased rate Excessive upper thoracic motion with respiration Decreased diaphragmatic amplitude Presence of passive congestion Sites of passive congestion Achilles tendons Popliteal spaces Lateral thighs Inguinal regions 4

5 Sites of passive congestion Axillary folds Supraclavicular areas Suboccipital areas Epitrochlear spaces Goals of Treatment Reduce sagital plane distortion Increase diaphragmatic amplitude Balance thorax toward inhalation position (get rid of the furniture problem) Patterns 1923 A.F. McWilliams, DO Central Spinous Nervous Centers or Primary Lesions 1924 S.C. Edmiston,DO Physiologic Mechanics 1931 A.F. McWilliams Combination Lesions 1937 Harold Magoun, DO Basic Lesions 1951 Denslow Areas of Most Notable Stress 1964 W. Dunnington, DO A Musculo-skeletal Stress Pattern 1979 J. Gordon Zink, DO An Osteopathic Structural Examination and Functional Interpretation of the Soma Common Compensatory Pattern A model developed by Zink focusing on fascial distortion and its effect on the respiratory/circulatory systems of the body. Distortion of the thoraco-abdomino-pelvic (TAP) cylinder and its effect on diaphragmatic motion and venous/lymphatic drainage. Examination performed with patient in supine position Common Compensatory Pattern (Spinal) 5

6 Fascial pattern in CCP Evidence supporting the prevalence of CCP: Research by Ken Johnson, DO and Neal Cross, PhD Measurement of lumbar facet angles Long-term asymmetry should be reflected in vertebral structure Hypotheses of Etiology of the CCP Response to postural stresses and gravity Viscerosomatic reflexes In-utero torsions coriolis effect Western civilization right handed world Significance of CCP Creates framework for interpretation of the significance of asymptomatic somatic dysfunction Organizes a regional examination Directs attention to spinal transitional areas Significance of Spinal Transitional Areas in CCP Areas of crossover points of compensatory curves Areas of change of anatomical characteristics Areas of changes of motion characteristics Areas of mechanical stress 6

7 Examination performed with patient in supine position Implications for Treatment Look to uncompensated areas Focus on spinal transitional areas Pay attention to the front of the back and Finally The Collected Works of J. Gordon Zink, DO, FAAO, available through the AAO Thank you very much! Contains the published works of Dr. Zink, many unpublished works, and hours of video and audio recordings of his teachings. 7